Appraising the self-assessed support needs of Turkish women with breast cancer

The purposes of this study were to establish the range of needs of women with breast cancer and to examine how women's needs might form clusters that could provide the basis for developing a standardized scale of needs for use by local breast care nurses in the evaluation of care. The sample consisted of 143 women with breast cancer who were admitted to the outpatient and inpatient oncology clinics in a university hospital in Erzurum, Turkey. The data were collected by questionnaire, and included demographic characteristics and the self-assessed support needs of women with breast cancer. Statistical analyses have shown that the standardized scale of needs has statistically acceptable levels of reliability and validity. The women's support needs mostly clustered in Family and Friends (79%) and After Care (78.3%). The most frequently required support category was Family and Friend; however, the women were in need of support of all categories. In terms of age ranges, there are statistically significant differences in relation to Femininity and Body Image, and Family and Friends of the seven categories. Women experienced a high level of needs associated with a diagnosis of breast cancer. The results in this study should increase awareness among cancer care professionals about a range of psychosocial needs and may help them target particular patient groups for particular support interventions.     

Racial/ethnic differences in adequacy of information and support for women with breast cancer

BACKGROUND: Providing breast cancer patients with needed information and support is an essential component of quality care. This study investigated racial/ethnic variations in the information received and in the availability of peer support. METHODS: In total, 1766 women who were diagnosed with nonmetastatic breast cancer and reported to the Los Angeles County Surveillance, Epidemiology, and End Results registry from June 2005 to May 2006 were mailed a survey after initial treatment. Among accrued cases, 96.2% met eligibility criteria (n = 1698), and 72% completed the survey. Race/ethnicity categories were white, African American, and Latinas (2 categories indicating low or high acculturation, which was determined by using the Short Acculturation Scale for Hispanics). Outcomes included receipt and need for treatment-related and survivorship-related information, difficulty understanding information, and support from women with breast cancer. RESULTS: More women reported receiving treatment-related information than survivorship-related information. After adjusting for sociodemographic, clinical, and treatment factors, a higher percentage of low acculturated Latina women desired more information on treatment-related and survivorship-related issues (P < .001). Significantly more Latina low acculturated women than white women reported difficulty understanding written materials, with 74.5% requiring help from others. A higher percentage of all minority groups compared with whites reported no contact with other women with breast cancer (P < .05) and reported less contact through family/friends (P < .05). Women rated the benefit of talking to other women high, particularly with emotional issues. CONCLUSIONS: Continued efforts to provide culturally appropriate information and support needs to women with breast cancer are necessary to achieve quality care. Latinas with low acculturation reported more unmet information and care support needs than women in other racial/ethnic groups.     

Experiences of Spouses of Women with Breast Cancer: A Content Analysis

Introduction: In addition to the affected person, diagnosis and treatment of breast cancer also severely affects her husband. Therefore, it is worth paying attention to the needs of husbands of women with breast cancer. Therefore, the aim of the present study was to explain the experiences of spouses of women with breast cancer. Method: The present study was a qualitative study with conventional content analysis approach. Purposive sampling was carried out by selecting 6 spouses of women with breast cancer. Data were collected through semi-structured interview. The recorded interviews were transcribed verbatim. Content analysis was used to reduce and name the data, obtain analytical codes, and finally recognize the theme. Results: Data analysis resulted in the extraction of 4 categories of couples’ mental challenges, multifaceted romantic meditation, multifaceted traumas caused by the disease, dual energies (inductions) of relatives, and 12 subcategories. Conclusion: In spite of suffering from all the challenges and traumas, husbands of women with breast cancer have not left their wives alone and have done their best to improve their lives; so, we can raise ““Scarifying your life to save your wife’s life”” as an extract from the experience of spouses of women with breast cancer. Knowing and understanding this point by clinical staffs and policy makers can provide pave the way for planning to provide comprehensive support to these men.     

Reports of information and support needs of daughters and sisters of women with breast cancer

The aim of this study was to describe the information and support needs of women who have primary relatives with breast cancer. The Information and Support Needs Questionnaire (ISNQ) was developed and revised from previous qualitative and pilot studies. The ISNQ addressed concepts of the importance of, and the degree to which, 29 information and support needs related to breast cancer had been met. The study sample consisted of 261 community-residing women who had mothers, sisters, or a mother and sister(s) with breast cancer. Data were collected using a mailed survey. In addition to the ISNQ, additional items addressed family and health history, breast self-care practices, perception of the impact of the relative's breast cancer and other variables. Also included were established and well-validated measures of anxiety and depression. The findings document women's priority information and support needs. The information need most frequently identified as very important was information about personal risk of breast cancer. Other highly rated needs addressed risk factors for breast cancer and early detection measures. Generally, the women perceived that their information and support needs were not well met. These findings illuminate needs of women for more information and support when they have close family relatives with breast cancer and opportunities for primary care providers to assist women in addressing their needs.     

Determination of Information and Support Needs of First Degree Relatives of Women with Breast Cancer

Background: Breast cancer is the most frequent type of cancer among women in the world and the mostcommon cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the mostfrequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women havingbreast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attemptto determine the information and support needs of women whose first-degree relatives have breast cancer andto what extent these needs are met. Methods: The research sample consisted of 156 women. Questionnaire Formand Information and Support Needs Questionnaires were used as the data collection tools. Results: Informationneed score averages (x̄:3.72±0.19) of women included in the research sampling were found to be higher than theirscore averages of support needs (x̄:3.24±0.41). Conclusion: Information needs which were indicated by womenas very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), whilesupport needs which were indicated by women as very important were learning how to perform BSE, women’sanxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a healthprofessional. It is recommended that nurses and other medical staff should give information to women whosefirst-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment optionsand protection as well as prevention.     

Postmastectomy educational needs and social support

Due to shorter hospitalization periods and changes in surgical procedures, breast cancer patients have less inpatient contact with rehabilitation resources. A questionnaire related to educational needs and social support was mailed statewide to 2,000 postmastectomy women who had received a Reach to Recovery visit. The findings are based on quantitative data reported by 933 women and from 27 women in follow-up interviews. Respondents ranked their educational needs in six categories from greatest to least importance as follows: (1) information about breast cancer, (2/3) personal hygiene/exercise and nutrition/weight control (both ranked of equal importance), (4) prosthesis/clothing information, (5) social support, and (6) sexual issues. Performance on the knowledge assessment correlated directly with the amount of educational experience and inversely with age. Respondents who lived in communities of less than 2,500 were less informed than those from other locations. Participation in formalized support groups was infrequent (11%). The major source of information was the media, with 88% indicating they would watch television programs about breast cancer. Thirty-three percent of the respondents indicated they owned a video cassette recorder (VCR); about 93% said VCRs were available for rent in their community. Work associates were identified as a group that encouraged information seeking; health care professionals were the most successful in motivating women to participate in support groups.     

Bilateral oophorectomy and breast cancer risk reduction among women with a family history

PURPOSE: We investigated whether removal of the ovaries is an appropriate risk reduction option for women at elevated risk of breast cancer based on family history of breast cancer. PATIENTS AND METHODS: This question was investigated among a group of 851 women less than age 60 who underwent bilateral oophorectomy between 1970 and 1994 for various reasons. Questionnaire information was collected from 680 (80%) and women were grouped into family risk categories. Reported occurrences of breast cancer were compared to expected rates based on the Gail model. RESULTS: The number of observed breast cancers among women in the cohort was lower than expected for all levels of familial risk, with women in the highest risk groups experiencing about half to one-fourth the number of cancers expected. The apparent protective effect of oophorectomy was stronger among women who were both premenopausal and less than age 50 at time of surgery. CONCLUSION: These data support oophorectomy as a valid breast cancer prevention option for women of all risk levels.     

Research review of the supportive care needs of spouses of women with breast cancer.

PURPOSE/OBJECTIVES: To conduct an integrative review of the research describing the needs of spouses of women with breast cancer for direction in planning nursing interventions to meet their supportive care needs. DATA SOURCES: Published articles and bibliographies from pertinent articles. DATA SYNTHESIS: A base of knowledge exists regarding the emotional and psychosocial needs of spouses of women with breast cancer. Less is known about their spiritual, practical, and physical needs. Very little research has explored nursing interventions and supportive care needs. CONCLUSIONS: Definite knowledge gaps exist regarding the needs of spouses of women with breast cancer. More research is required to develop and evaluate interventions that focus on these needs. IMPLICATIONS FOR NURSING PRACTICE: A diagnosis of breast cancer is a distressing time for both women and their spouses. Ongoing research and the development of interventions are necessary to help spouses cope with the stress throughout the illness so that they may support their wives.     

The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors

Due to improvements in medical treatment and survival following breast cancer, researchers have turned their attention to investigating the needs of breast cancer survivors. There is disagreement about the extent to which survivors continue to experience psychological morbidity after treatment ends. Whilst the majority of women adjust well to breast cancer, some may have continued psychosocial needs. Available research suggests that younger pre-menopausal women are at increased risk of psychological morbidity following breast cancer. The present study aimed to gather preliminary qualitative data on the psychosocial needs of breast cancer survivors and to identify the shared and unique needs of younger versus older survivors. A qualitative methodology was chosen as this was a relatively unexplored area of enquiry. Patients treated for early-stage breast cancer who had completed their hospital-based treatment 6-24 months prior to participation were recruited. Sampling was discontinued when informational redundancy was achieved. Eighteen telephone interviews were conducted. A wide variety of on-going psychosocial and information needs were reported by breast cancer survivors including support needs, psychological needs, practical needs, physical needs and information needs. Younger women reported more needs than their older counterparts. Several needs reported by younger women were directly related to being of younger age or pre-menopausal at the time of diagnosis. Clinical implications are discussed.     

Factors Affecting Preferences of Iranian Women for Breast Cancer Screening Based on Marketing Mix Components

Background According to recent statistics, the breast cancer rate is growing fast in developing countries. In North West of Iran, the incidence of breast cancer after esophageal and gastric cancers has the highest rate. Previous studies have also indicated that women in this region show reluctance to do breast cancer screening. There is a great need for change to promote breast cancer screening among women. Social marketing is a discipline that uses the systematic application of commercial marketing techniques to promote the adoption of behavior by the target audience. Materials and Methods In the present qualitative study, thirty-two women with breast cancer were interviewed about their experiences of breast cancer screening. A semi-structured interview guide was designed to elicit information speci c to the 4 P's in social marketing. Results Three main categories emerged from the analysis price, service and promotion. Subcategories related to these main categories included factors effective in increasing and decreasing cost of screening, current and desirable features of screening services, and weakness of promotion. Conclusions Screening programs should be designed to be of low cost, to meet patients' needs and should be provided in suitable places. Furthermore, it is essential that the cultural beliefs of society be improved through education. It seems necessary to design an executive protocol for breast cancer screening at different levels of primary health care to increase the women's willingness to undergo screening.     

Breast biopsy support program: collaboration between the oncology clinical nurse specialist and the ambulatory surgery nurse.

Nurses play a vital role in the care of women admitted to an ambulatory unit for a breast biopsy. This paper offers one aspect of a psychosocial model that the oncology clinical nurse specialist and the ambulatory surgery nurse can use collaboratively to meet each woman's needs during this critical period. Goal-directed communications are the focus of this paper. Five specific techniques are described and can be used before biopsy reports are known, after women are informed that results are either negative or pending, and after reports are confirmed as positive. Psychosocial support is recognized as an important aspect of nursing care provided to women diagnosed with breast cancer. Although only 10% of women undergoing breast biopsies are diagnosed with malignant lesions, nurses must provide optimal support and guidance to every woman admitted for this surgical procedure.     

Mapping the quality of life and unmet needs of urban women with metastatic breast cancer

Enhancing quality of life and reducing the unmet needs of women are central to the successful management of advanced breast cancer. The objective of this study was to investigate the quality of life and support and information needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Melbourne, Australia. A consecutive sample of 105 women with advanced breast cancer completed a questionnaire that contained the European Organization of Research and Treatment of Cancer Quality of Life Q-C30 and the Supportive Care Needs Survey. Between one quarter and a third of the women reported difficulties with their physical, role and social functioning, and a little over a quarter of the women reported poor global health status. Fatigue was a problem for most women. The highest unmet needs were in the psychological and health information domains. Almost no differences in unmet needs were detected when comparing different demographic and disease characteristics of women. Health care providers should routinely monitor the quality of life and needs of women with advanced breast cancer to ensure that appropriate treatment, information or supportive services are made available.     

From Love and Fidelity to Infidelity- Individual Experiences of Women with Breast Cancer Regarding Relationships with Their Spouses

Background and Objective: Breast cancer and its treatment processes not only involve the patients but also their spouses and can impact on mutual relationships. Spouses of women with breast cancer may experience devastating consequences of the disease in their marital and sexual relationships. Therefore, in the present study we aimed to investigate individual experiences of women with breast cancer in their relationships with their spouses. Materials and Methods: This was a qualitative study with a conventional approach to content analysis. A purposive sampling method was used to select 12 patients with breast cancer visiting the Chemotherapy Clinic in Zabol in 2016. Semi-structured interviews were employed for data collection. Data trustworthiness was checked and data were analyzed based on the steps proposed by Graneheim and Lundman. Ethical issues were considered. Results: Three main categories and ten sub-categories were extracted. The three main categories were surrounded by misery, from emotional to practical companionship and influencebeing imposed upon someone else. Conclusion: The findings showed paradoxical experiences of the women under study ranging from love and fidelity to infidelity. This indicates that some spouses do not adequately support for their sick wives. Therefore, health professionals should provide support, guidance and training for couples, including sex therapy and counseling services, so that spouses can better support their wives.     

Breast cancer-race,ethnicity, and survival: a literature review

A review of the literature on breast cancer was conducted to identify gaps in knowledge as it relates breast cancer risk, race, and survival. The discussion has been divided into three broad categories: (1) breast cancer basics and the relationships between risks, race, and survival; (2) influence of race and socioeconomic status on breast cancer morbidity and mortality; and (3) relationship between age and mammography screening. All of the cited studies reveal evidence of a linkage between race and breast cancer survival, however, the effects of socioeconomic factors and race needs to be examined. Results suggest that African-American women and lower income women need to be targeted for early detection. Many of the analyses among younger women (20–39 years) reported that very little disease occurrence in young black women was associated with the socioeconomic factors studied. Conclusions from all studies indicate that more aggressive screening and public education programs directed toward younger black women is warranted. The gaps in knowledge identified included the lack of an explanation of early onset breast cancer with high penetrance as well as an explanation of African-American women's resistance to self-examination and mammography screening and other barriers to diagnostic treatment. Future studies should also examine the link between familial breast cancer and genetic mutations.     

Supportive care of rural women with breast cancer in Tasmania, Australia: changing needs over time

Providing for patients' psychosocial needs is a potential means of minimising cancer morbidity. Needs assessments can guide responsive patient-centred care. A longitudinal survey of women with early breast cancer consulting a breast nurse in a primarily rural state of Australia was undertaken to measure unmet supportive care needs, identify changes in unmet needs across time and compare results with previous studies. Needs assessments were completed with the Supportive Care Needs Survey (SCNS) at 1 month (n = 74) and 3 months (n = 83) post-diagnosis. Access to services was also examined. High levels of psychological and health system and information needs were identified at 1 month post-diagnosis, but these decreased significantly at 3 months post-diagnosis. Sexuality domain needs increased significantly during the same time. Compared to a previous SCNS study of rural women with breast cancer, unmet supportive care needs in this study were significantly lower than previously reported, although assistance with energy levels (i.e. fatigue) continues to be an unmet need for women with breast cancer. Results suggest there have been positive cultural changes within healthcare systems, specifically in better informing patients and providing support. Although services appear to be more responsive to breast cancer patients, significant unmet needs still exist.     

Women's experience of breast conserving treatment for breast cancer

The implementation of the National Breast Screening Programme in the UK, and subsequent increase in early detection of small cancers, has facilitated breast conserving treatment for more women with a breast cancer diagnosis than ever before. While a substantial body of literature has evolved regarding psychosocial morbidity and support needs of women at diagnosis and during treatment, there are specific gaps in the current knowledge base. The purpose of this study was to describe the experiences of women who had breast conserving treatment for early breast cancer, focusing on issues related to diagnosis, surgery, and radiotherapy. The study was designed within the context of clinical audit, with a view to informing service development. Seventy-six women who had undergone breast conserving surgery within the last 3-12 months, completed a self-report questionnaire. Findings indicated that although the majority of women expressed satisfaction with their treatment overall, a number of specific areas require attention from healthcare professionals. Further research is required to validate these findings and to explore: potential implications of different referral routes; information and support needs preceding definitive diagnosis; particular needs of those women with ductal carcinoma in situ (DCIS) vs. invasive disease; 'end of treatment' and ongoing information and support needs.     

Progestogen use and decreased risk of breast cancer in a cohort study of premenopausal women with benign breast disease.

A cohort study of 1,150 premenopausal French women with benign breast disease diagnosed in two breast clinics between 1976 and 1979 was carried out to analyse the relationship between progestogen use and the risk of breast cancer. The follow-up accumulated 12,462 person-years. The risk of breast cancer was estimated using a Poisson regression analysis on person-time data and the proportional hazards model. In the latter analysis, cumulated progestogen use and age were considered as time-varying covariables and adjustment was performed on the main risk factors for breast cancer. Neither overall progestogen use nor the duration of use was found to be significantly associated with the risk of breast cancer. When progestogens were classified into two categories according to their hormonal potency (19-nortestosterone derivatives vs other progestogens), 19-nortestosterone derivative use was found to be significantly associated with a lower risk of breast cancer. In the adjusted model, the corresponding risk of breast cancer was 0.48 (95% confidence interval 0.25-0.90). In addition, there was a linear trend in the decrease of the relative risk of breast cancer with the duration of use (P = 0.02). These results do not support the hypothesis that progestogens might increase the breast cancer risk. They suggest, instead, that treatment with 19-nortestosterone derivatives might have a beneficial effect on the risk of breast cancer in women with benign breast disease.     

The experiences,needs and concerns of younger women with breast cancer: a meta‐ethnography

Objective: This meta‐ethnography synthesises the evidence on the experiences, needs and concerns of younger women with breast cancer. Methods: Using a method called ‘reciprocal translation’ we developed a conceptual model to reflect the local and social contexts, issues, processes, needs and concerns of importance in this literature. Findings: Key findings relate to the particular point in the life‐course at which young women with breast cancer stand. Issues for these women relate to feeling different as a result of cancer, fear of recurrence, feeling ‘out of sync’ and altered embodied subjectivity. Young women with breast cancer use three processes to integrate the changes that cancer brings, namely, balancing, normalising and changing. Our conceptual model also highlights young women's needs, primarily for support, information, childcare, counselling and spiritual support. Areas of reproduction, fertility and sexuality were also of particular concern. The included papers have methodological limitations that impact on our findings, such as opportunistic data analyses, lack of theoretical frameworks and limited reference to socio‐cultural factors. Conclusion: The conceptual model developed as a result of this meta‐ethnography provides a basis for practitioners to address these young women's concerns more adequately and comprehensively. Copyright © 2010 John Wiley & Sons, Ltd.     

Feeling like me again: a grounded theory of the role of breast reconstruction surgery in self‐image

The present study aimed to develop a theoretical understanding of the role of breast reconstruction in women's self‐image. Semi‐structured interviews were conducted with 10 women from breast cancer support groups who had undergone breast reconstruction surgery. A grounded theory methodology was used to explore their experiences. The study generated a model of ‘breast cancer, breast reconstruction and self‐image’, with a core category entitled ‘feeling like me again’ and two principal categories of ‘normal appearance’ and ‘normal life’. A further two main categories, ‘moving on’ and ‘image of sick person’ were generated. The results indicated a role of breast reconstruction in several aspects of self‐image including the restoration of pre‐surgery persona, which further promoted adjustment.